Blue Choice PPO Bronze Plans

Blue Choice PPO Bronze Plans

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Blue Choice PPO Bronze Plans offer the same benefits as Blue PPO Bronze Plans, but are coupled with the Blue Choice PPO network, a smaller version of the “standard” Blue Cross Blue Sheild of Illinois PPO network. If you can accept some reduced hospital and physician choice, BlueChoice Bronze Plans may be a great option for you. All Blue Choice Bronze plans offer the same set of essential health benefits, quality and amount of care.

Blue Choice PPO Bronze Plan Costs

Health insurance costs include monthly premium payments, individual/family deductibles, out-of-pocket expenses, copayments, and coinsurance. Here is what you can expect with Bronze® plans:

Individual in-network deductibles of $5,000 or $6,000

80% or 100% coinsurance after deductible

80% or 100% coinsurance prescription drug coverage after deductible

Coinsurance of 100% or 80% percent of services provided in-network

Annual out-of-pocket maximum of $6,000 and $6,350 for individuals and $12,700 for families

By using a contracting BCBS Choice PPO hospital, doctor or specialist you are able to save on premiums and the cost of covered services. You do not need to select a primary care physician or obtain a referral to see a specialist.

Although you can go to the hospital or doctor of your choice, your benefits under a Bronze® plan will be higher, and your costs lower, when you use the services of participating PPO or BlueChoice® providers.

Maternity Coverage

As with all individual Blue Cross and Blue Shield of Illinois plans, the freedom of not having to select a primary care doctor or obtain a referral to see a specialist

More Plan Details

It’s important to know the critical features of the health plan you are considering. Each plan’s Outline of Coverage provides brief descriptions of the basic provisions the Bronze plans, as well as details on policy renewability, benefit exclusions and coverage limitations.

Prescription Drug Coverage

For the Blue PPO Bronze and Blue Choice Bronze Plans, there is a prescription drug card benefit that includes a coinsurance after your deductible. This benefit is not immediately available and subject to the deductible.

There is a also a Home Delivery prescription benefit available with these 3 deductible options where you can receive a 90 day supply in the mail for the cost of a 60 day supply and is subject to a maximum cost of $300 per prescription.

Outpatient Prescription Drug Benefit

Bronze Plan 005

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Preferred Generics

80% after deductible

100% after deductible

Non-Preferred Generics

80% after deductible

100% after deductible

Preferred Formulary

80% after deductible

100% after deductible

Non-Preferred Formulary

80% after deductible

100% after deductible

Specialty

80% after deductible

100% after deductible

Plan Renewals

Your BCBSIL policy can ONLY be terminated for the following reasons:

Failure to pay

The plan is discontinued (90 days notice given with an option to convert to any plan we offer)

Discovery of fraud or an intentional misrepresentation of facts (30 days prior written notice given)

If you no longer reside, live or work in an area where we are authorized to do business

Blue Choice PPO Bronze® Limits

Every insurance plan has limitations. These limits are there to keep health care costs down for everyone. A pre-existing condition is just one example of a plan limitation. For example:

A pre-existing condition may limit or exclude your participation in a plan.

There is a waiting period of 365 days for pre-existing conditions, including optional maternity coverage.

This means your health care expenses related to that specific condition will not be covered by the plan during the specified time.

It’s important to know the limitations of your health plan. For a list of exclusions and limitations, see the benefit summaries.

Add-ons and Plan Options

You can customize any Bronze plan to add-on dental insurance.

Optional Dental Coverage

Covers cleanings, check-ups and other preventive procedures immediately – no waiting period

One of the highest maximum benefit amounts available – up to $1,500 per person per year

Up to 20% discount for orthodontic services at participating providers